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General NPI Number Information
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NPI Number | 1801116967
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Entity Type | Individual
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Provider Name | AMANDA MARIE MCCAULEY-THORNBERRY D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/10/2010
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 109 N MIDDLETOWN RD
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City | PARIS
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State | KY
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Zip | 40361-2134
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Country | US
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Telephone | 859-987-7474
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Fax | 859-987-7474
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Provider Business Mailing Address
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Address Line | 141 BOURBON HILLS DR
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City | PARIS
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State | KY
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Zip | 40361-2414
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Country | US
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Telephone | 859-588-1001
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Fax | 859-987-7474
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8901
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8901
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License Number State | KY
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